Health Insurance Waiting Periods: What You Need to Know

Health insurance is an essential aspect of life. It provides a financial safety net in times of medical emergencies. Health insurance has numerous benefits, from covering hospitalisation expenses to ensuring access to quality healthcare without worrying about the cost. However, to fully leverage these benefits, it is essential to understand all aspects of your mediclaim policy. One key element that requires careful consideration is the ‘waiting period.’ Knowing how waiting periods work can help you make informed decisions. It ensures that your health insurance plan aligns with your needs when you need it most.   

What Is the Waiting Period in Health Insurance?  

The waiting period in health cover plans is when you must wait before your policy covers certain medical expenses. This period starts from the date your policy begins. It can vary depending on the insurance provider and the type of treatment. During this time, you cannot claim benefits for specific conditions or treatments. The health cover waiting period helps insurers manage risk. It ensures that policyholders do not immediately claim for pre-existing conditions or new illnesses.   

Why Is There a Waiting Period for Health Insurance?  

The waiting period for health insurance serves several key purposes. It helps insurers manage risk by preventing immediate claims for high-cost treatments or pre-existing conditions. This waiting period also encourages individuals to maintain continuous coverage. It also prevents individuals from purchasing insurance only when they anticipate needing costly care. By including waiting periods, insurers can offer more affordable premiums while ensuring that the system remains effective for all policyholders.  

Types of Waiting Periods in Health Insurance  

Health insurance policies come with different types of waiting periods, each designed to manage specific aspects of coverage. Here is a breakdown of the common types:  

• Initial Waiting Period  

This is the standard waiting period that applies to most medical insurance policies. It usually lasts for 30 days from the start of the policy. During this period, you cannot make any claims, except for accidental hospitalisation. This period allows the insurer to prevent immediate claims from new policyholders.  

• Specified Disease/Procedure Waiting Period  

For certain specified diseases or medical procedures, there is a waiting period of 24 months. During this time, claims related to these specific conditions will not be covered. This helps insurers manage the risk of covering high-cost treatments immediately after the policy is purchased.  

• Pre-existing Condition Waiting Period  

If you have any pre-existing health conditions when you buy a health insurance policy, you will need to wait for 36 months. Only after this period will your insurance cover treatment related to these conditions. This is one of the longest waiting periods and is crucial for managing long-term health risks. If you are exploring health insurance for senior citizens, consider getting help from experts. They can help you to find the right plan and maybe with a reduced waiting period.   

• Critical Illness Waiting Period  

There are specific initial and survival periods—typically 90 days and 30 days, respectively. This ensures that the policy coverage is available for those who genuinely need it.  

• Maternity Cover + Newborn Baby Inclusion Waiting Period  

Maternity benefits and the inclusion of a newborn baby under the policy often come with a 24 to 48-month waiting period. It also depends on the policy type. This insurance waiting period ensures that these benefits are used by policyholders who maintain their coverage over time.  

• Accidental Hospitalisation    

Accidental hospitalisation is typically covered from day one of the policy. There is no waiting period for claims arising from accidents. This allows you to receive immediate coverage for unexpected injuries.  

Health Insurance Plans and Their Waiting Periods  

Here are three comprehensive health insurance plans with their waiting period offered by ManipalCigna:  

1. Pratham - Essential health insurance coverage to help you begin your journey with confidence 

ManipalCigna Sarvah Pratham Health Insurance is an essential shield for your health insurance journey. Sarvah Pratham is designed to offer essential coverage while ensuring that unexpected medical expenses don't strain your savings. This plan offers dependable support to ensure you and your family remain financially secure during significant medical events. 

Pratham is designed to provide you with comprehensive coverage up to Rs 3 Cr. It focuses on critical illnesses like cancer, heart conditions, stroke and major organ transplants. This plan offers features like the GULLAK – 10x Bonus Guaranteed, which doubles your Sum Insured each year up to 1000%. The Sarathi option offers coverage from the 31st day for pre-existing conditions related to specific illnesses without the standard 36-month waiting period. Additionally, it includes unlimited restoration of your Sum Insured from the second claim onwards. Here are the details of this insurance waiting period:   

1. Uttam – Experience the freedom of infinite Health Coverage 

ManipalCigna Sarvah Uttam is the ultimate personalized and comprehensive health insurance plan designed for complete peace of mind. The infinite power of this plan ensures you're fully protected against high medical expenses and unexpected health challenges. 

Uttam provides personalised health insurance coverage up to Rs 3 Cr. It ensures that you and your loved ones are protected against high medical costs. It features GULLAK – a 10x Bonus Guaranteed, which doubles your Sum Insured each year. Sarathi, which covers pre-existing conditions like asthma, diabetes and hypertension after just 30 days. The plan also offers extensive maternity and newborn coverage, which makes it a great choice for someone who is exploring medical insurance plans for a family. Check the waiting period of this insurance plan here:   

1. Param – Zero Waiting Period, Instant Peace of mind 

Health problems don’t wait for any one, then why should you. Experience the freedom of comprehensive health coverage from day one with ManipalCigna Sarvah Param. From the moment you sign up our policy ensures you're protected against unforeseen medical expenses. Say goodbye to delays and enjoy peace of mind knowing that your health is our priority. 

Param is a comprehensive health insurance plan offering coverage up to Rs 3 Cr. One of its standout features is that this is a zero-waiting period of health insurance for pre-existing diseases. This means you can get immediate coverage for existing conditions. Additionally, Param also includes GULLAK, which offers a 10x bonus Guarantee and unlimited restoration of your sum insured. Additionally, it offers personal accident cover. It pays up to 200% of the Sum Insured if the death or disablement occurs while travelling as a fare-paying passenger. Following are the details of the waiting period:  

Tips for Choosing the Right Health Insurance Plan  

It is essential to keep the following points in mind when dealing with health insurance:  

• Consider your health conditions and those of your family to find a plan that covers necessary treatments and services.  

• Choose a plan with waiting periods that suit your health needs and conditions. Waiting periods differ between insurance providers, so compare options carefully.  

• Ensure the plan covers essential services like hospitalisation, outpatient care and any additional benefits you might need. Different policies and conditions have unique waiting periods, such as for pre-existing conditions or specific diseases.  

• Find a plan with affordable premiums and reasonable out-of-pocket costs that fits your budget.  

Conclusion  

Waiting periods in health insurance are an essential aspect to consider when selecting a policy. They ensure that both insurers and policyholders are protected. By being aware of the different types of waiting periods and how they apply to your chosen plan, you can plan your healthcare needs effectively.  

Secure Your Health with ManipalCigna Health Insurance  

Choose ManipalCigna Health Insurance for comprehensive coverage that keeps you protected against unexpected medical expenses. With a wide range of health insurance plans tailored to meet your unique needs, you can ensure your health and financial security. Act now and invest in a plan that offers access to quality healthcare when it matters most.  

Visit our website today to explore our range of Health Insurance plans.  

FAQs  

What is the purpose of a waiting period?  

The waiting period in health insurance protects insurance companies from immediate high-cost claims.  It ensures that the system remains sustainable and effective for policyholders. It prevents individuals from purchasing insurance only when they anticipate needing costly treatments. This period also helps in keeping premiums more affordable for everyone by spreading the risk over time.  

What is the 'Zero Waiting Period' in health insurance?  

A 'Zero Waiting Period' in health insurance means that certain conditions or treatments are covered immediately from the start of the policy. Typically, this applies to accidental hospitalisation, where you can claim benefits right away. It also ensures that you get the coverage you need for unexpected injuries.  

Will a health insurance claim be accepted if a disease is diagnosed during the plan term?  

Typically, it will be accepted if the waiting period for that specific condition is completed. For diseases diagnosed after the waiting period, your insurance will cover the associated medical expenses as per the policy terms. However, it would also depend on your policy terms and insurer.  

How can I reduce my waiting period for health insurance?  

You can opt for plans that offer shorter waiting periods or ones that waive the waiting period for pre-existing conditions. Some insurers offer the option to buy add-ons or rider benefits that reduces or eliminates the waiting period for specific conditions. Additionally, maintaining continuous coverage without a break can sometimes help in reducing waiting periods for future policies.